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Organization

COEUR D'ALENE PEDIATRICS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CARI WARREN (OFFICE ADMINISTRATOR)
(208) 667-0585
Entity
Organization

Contact information

Practice address
700 W IRONWOOD DR, SUITE 155, COEUR D ALENE, ID 83814-2656
(208) 667-0585
(208) 667-0876
Mailing address
700 W IRONWOOD DR, SUITE 155, COEUR D ALENE, ID 83814-2656
(208) 667-0585
(208) 625-2075

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010006210
REGENCE BLUE SHIELD
ID
05
002584600
ID
05
002585300
ID
05
7092836
WA
01
81869
BLUE CROSS
ID
01
8A976
BLUE CROSS OF IDAHO
ID
Enumeration date
12/22/2006
Last updated
05/29/2025
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